Abstract 5419
Background
Multiple mechanisms can directly influence body compositions (bcomp) in cancer: tumor-dependent chronic inflammation, leading to (a) anorexia and multiple neuroendocrine changes, (b) patient-dependent treatment related effects, and (c) in esophageal cancer, mechanical alterations with weight loss. Supportive management depends on understanding the cancer frailty determinants that lead to poor outcomes.
Methods
We retrospectively identified MEC patients (pts) treated in Toronto, Canada (2007-2014). Bcomp was assessed at presentation, using computed tomography, and included skeletal muscle index (SMI), visceral (VA) and subcutaneous adiposity (SA). Two outcome-blinded radiologists (Intraclass correlation, 0.92-1.00) assessed the L3 level, using SliceOMatic software. Published sex and BMI-dependent Bcomp cut-offs were used to define cancer associated sarcopenia. Cox proportional hazard models generated adjusted hazard ratios (aHR) and Kaplan-Meier curves estimated survival.
Results
Of 127 pts, 83% were male; 94% Caucasian; median age at diagnosis 61y (29-88); 80% were stage IV de novo. Mean body mass index (BMI) was 24.7; 69%/27%/3% were adeno/squamous cell /large cell carcinoma. Median overall (OS) and progression free survival (PFS) were: 6.4 (OS) and 1.5 mos (PFS). Median follow-up time was 5.6 mos. 49% were sarcopenic at baseline; of 44 pts with BMI > =25, 41% were sarcopenic. Univariable analyses identified albumin, LDH, and arcopenia as being inversely associated with OS and PFS. Multivariable models showed that sarcopenia was independently associated with worse OS (aHR=1.74, 95%CI 1.06-2.86, p = 0.03), and worse PFS (aHR=1.95, 95%CI 1.10-3.44, p = 0.02). In 76 pts receiving chemotherapy at diagnosis, less total adiposity (VA+SA) showed a trend towards worse OS (aHR=0.99 95%CI 0.99-1.00 p = 0.07 as continuous variable).
Conclusions
Sarcopenia at baseline is inversely related with OS and PFS in MEC. Our MEC patients had a higher incidence of sarcopenic obesity compared to cancer populations in the literature (9%). Future studies are needed to better characterize muscle and adiposity underlying biological importance in MEC.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
2107 - Role of Individualized Intervention(s) on Quality of Life (QOL) and Adherence to Adjuvant Endocrine Therapy in Premenopausal Women with Early-Stage Breast Cancer (BC): MyChoice Study
Presenter: Shahid Ahmed
Session: Poster Display session 2
Resources:
Abstract
5812 - Correlation between the density of tumor-infiltrating lymphocytes, immune cell subsets in tumor stroma and response to systemic therapy in breast cancer
Presenter: Cvetka Grasic Kuhar
Session: Poster Display session 2
Resources:
Abstract
4734 - BRCA1/2 Testing in HER2- Advanced Breast Cancer (ABC): Results from the European Component of a Multi-Country Real World Study
Presenter: Michael Patrick Lux
Session: Poster Display session 2
Resources:
Abstract
1686 - In vitro and in vivo rescue of resistance to BET inhibitors by targeting PLK1 in triple negative breast cancer.
Presenter: Cristina Nieto-jiménez
Session: Poster Display session 2
Resources:
Abstract
5020 - Neoadjuvant endocrine therapy in combination with melatonin and metformin in locally advanced breast cancer
Presenter: Tatiana Semiglazova
Session: Poster Display session 2
Resources:
Abstract
5082 - Melatonin and metformin in neoadjuvant chemotherapy in locally advanced breast cancer
Presenter: Tatiana Semiglazova
Session: Poster Display session 2
Resources:
Abstract
2642 - Patient-tailored tamoxifen dosing based on an increased quantitative understanding of its complex pharmacokinetics: A novel integrative modelling approach
Presenter: Anna Mueller-Schoell
Session: Poster Display session 2
Resources:
Abstract
2461 - Lack of benefit of neoadjuvant pertuzumab in high risk HER2 positive breast cancer. A retrospective case-control study of 355 cases with biomarker analysis.
Presenter: Manuela Tiako Meyo
Session: Poster Display session 2
Resources:
Abstract
4776 - Targeting CDCA3 to improve chemotherapy response in triple-negative breast cancer patients
Presenter: Kenneth O'Byrne
Session: Poster Display session 2
Resources:
Abstract
1674 - Activity of BET-proteolysis targeting chimeric (PROTAC) compounds in triple negative breast cancer
Presenter: María Del Mar Noblejas López
Session: Poster Display session 2
Resources:
Abstract